Stroke is the 3rd leading cause of death and one of the leading causes of adult long-term disability in the US, with high impact for African Americans. Since 90% of stroke survivors are functionally impaired, improving stroke outcomes is a major public health issue. Agencies such as CMS and the Joint Commission have implemented performance programs including quality indicators (QIs) which would ideally be selected based on impact on stroke-related outcomes, but such evidence is currently scant. The Institute of Medicine has stated